Deck 29: Burns

Question 1

A 51-year-old female patient tripped in the kitchen and fell against a deep fryer, splashing hot oil onto her right arm. Assessment reveals partial- and deep partial-thickness burns to her arm. You estimate that the burn covers 2% of her body. Which statement, made by the patient, reveals the most important information when determining the overall severity of the burn?

A) "I had a burn like this several years ago."
B) "I think that I lost control of my bladder."
C) "I have been a diabetic for several years."
D) "The doctor said that I scar very easily."

Answer 1

C

Question 2

A patient has a burn that completely encircles his right forearm and upper arm. After performing the primary assessment, the EMT's next action would be to:

A) evaluate and compare grip strength in the right and left hands.
B) check for motor, sensory, and a pulse in the right upper extremity.
C) ask the patient to rate the pain on a scale of one to ten.
D) carefully break the blisters to decrease the pressure caused by swelling.

Answer 2

B

Question 3

You are assessing a patient who was burned when she dropped a hot iron on her bare foot. Her foot is red and has a small partial-thickness burn near the ankle. When completing the prehospital care report, what mechanism would you document?

A) Scald burn
B) Flame burn
C) Electrical burn
D) Contact burn

Answer 3

D

Question 4

An intoxicated patient has suffered a burn to his left lateral thigh after passing out with his leg touching the side of a kerosene heater. Close examination of the burn reveals tough leathery tissue in the center of the burn with red skin with blisters surrounding it. Regarding the burn, which one of the following is true?

A) The inner portion of the burn is full thickness and the outer portion partial thickness.
B) The pain is originating from the more severely burned center of the injury.
C) The blister formation indicates that portion of the burn can be classified as full thickness.
D) The outer skin surrounding the burn can be medically described as eschar.

Question 5

A patient was burned when he accidentally ignited gasoline while working on his car. When performing the secondary assessment, what finding would indicate that the patient has suffered a partial-thickness burn?

A) Pink skin that is dry and painful to the touch on the left lower leg
B) Painful skin that is moist and contains blisters to the abdomen
C) Intact skin on the wrist that is red and dry and extremely painful when touched
D) Leathery skin on the thigh that exhibits little pain when touched

Question 6

When triaging multiple burn patients, the EMT would recognize which as suffering the most critical burn?

A) 41-year-old with a partial-thickness burn to the upper left arm
B) 22-year-old with a partial-thickness burn to the right hand
C) 58-year-old with a scald burn to the anterior chest
D) 12-year-old with a superficial burn to the neck and chest

Question 7

A 20-year-old waitress spilled hot coffee and burned her right forearm. When assessing the burn, you note a full-thickness burn surrounded by partial-thickness burns. She complains of pain in the surrounding partial-thickness burn, but not in the center where the full-thickness burn is located. As an EMT, you recognize that the patient does not localize pain to the center of the burn because of:

A) destruction of pain receptors in the epidermis.
B) injury to pain receptors in the subcutaneous layer.
C) damage to pain receptors located in the dermis.
D) destruction of the epidermal nerve endings.

Question 8

A 21-year-old male has sustained a severe burn to his left leg while working on an industrial furnace. Coworkers immediately doused his flaming pants and removed them. Your primary assessment reveals no threats to the airway, breathing, or circulation. While performing the secondary assessment on his leg, what finding would be most critical?

A) Partial-thickness burn completely encircling the knee
B) Pain described as "the worst I have ever felt"
C) Blisters on the lower leg that are broken and draining fluid
D) Skin on the posterior lower leg that is sloughing off

Question 9

You have been called for a 44-year-old male who was burned on the right hand and arm after falling against the hot door of an industrial incinerator. As you arrive on the scene, a nurse employed by the company informs you that he sustained a partial-thickness burn. Based on this information, the EMT should expect what characteristics at the burn site?

A) Intense pain and blister formation
B) Decreased pain but significant edema
C) Leathery skin that remains hot to the touch
D) Reddened skin with decreased pain sensation

Question 10

A fair-skinned patient was exposed to the sun and has a painful superficial burn to her upper back. As a knowledgeable EMT, you would recognize that the ________ layer(s) of the skin has been affected.

A) epidermal
B) dermal
C) epidermal and dermal
D) subcutaneous

Question 11

You are called by the owner of a restaurant for a female patron who spilled hot tea onto her right thigh. The secondary assessment reveals the burn area to be soft, red, and painful. The skin is intact with no blister formation noted, although some edema is present. Based on these assessment findings, you would recognize what category of burn?

A) Superficial
B) Partial thickness
C) Deep partial thickness
D) Full thickness

Question 12

Which statement made by the EMT indicates an understanding of calculating the body surface area (BSA) burned?

A) "The BSA can be quickly estimated before evaluating the status of the airway and breathing."
B) "Determining the BSA is an estimation and should never delay transport of the burn patient to the hospital."
C) "It is important to get an accurate estimation of the BSA burned since this will affect the care provided by the EMT."
D) "It is better to underestimate the BSA of a burn patient rather than overestimate the BSA."

Question 13

A patient, who is coughing, has suffered a superficial burn to the chest, arms, and face after pouring gasoline on a smoldering campfire. Which one of the following statements indicates that the EMT is properly caring for him?

A) "We are going to put ice packs to your chest to cool the burn."
B) "I am going to apply a special antibiotic lotion to the burned areas to prevent scarring."
C) "Throughout transport, I am going to listen to your lungs quite frequently."
D) "I need to clean the dirt from the burned area to prevent an infection."

Question 14

For which patient would the palm method be best to estimate the body surface area affected by a burn?

A) 21-year-old with superficial burns to the entire back and neck
B) 27-year-old with full-thickness burns to the backs of the legs and arms
C) 3-year-old with partial-thickness burns to the anterior chest and abdomen
D) 49-year-old with a partial-thickness burn to the inner thigh

Question 15

A young female, rescued from a burning apartment, has sustained partial- and full-thickness burns from her chest down to her feet. As such, the EMT would recognize the potential for the onset of:

A) hyperthermia.
B) hypertension.
C) hypoglycemia.
D) hypothermia.

Question 16

A female who had hot coffee thrown at her has a superficial burn to the right side of her face. After transferring the patient to the hospital emergency department for continued care, a new EMT asks you if the patient will have a permanent scar on her face. Which one of the following is your best reply?

A) "She will probably have some degree of scarring, but it will not be very noticeable."
B) "It depends; if the skin peels, she will probably be left with some degree of scarring."
C) "Since the burn was superficial, a small skin graft can be used to hide any and all scars."
D) "Since only the outer layer of skin was burned, there is little chance of scarring."

Question 17

What assessment finding would best indicate that a patient has suffered a full-thickness burn to his leg?

A) Red skin that is painful
B) Moist skin with blisters
C) Dry skin with little pain
D) Charred skin with intense pain

Question 18

A male patient who works in a steel fabricating plant has suffered a flash burn to his right arm and hand. What assessment finding would assist the EMT in determining that the burn is superficial and not partial thickness?

A) Presence of pain
B) Poor capillary refill
C) Absence of blisters
D) Strong radial pulse

Question 19

When classifying a burn as either superficial, partial thickness, or full thickness, the EMT would need to determine the:

A) percentage of body burned.
B) time of heat exposure.
C) agent causing the burn.
D) depth of the burn.

Question 20

A male patient has just been burned with hot water and has blisters on his left arm. The EMT would recognize that:

A) the burn can be classified as superficial.
B) fluid has collected between the layers of skin.
C) medium and large blood vessels have ruptured.
D) the burn shows signs and symptoms of infection.

Question 21

A student in a science lab has had an unknown chemical splashed into her eye. After assessing the airway, breathing, and circulation, the EMT would immediately:

A) examine the pupils and structures of the eye for damage.
B) identify the chemical and whether or not a neutralizing solution can be used.
C) flush the eye with copious amounts of tap water.
D) cover both eyes with sterile dressing and provide rapid transport to the hospital.

Question 22

You have been called for an intoxicated male who sustained a full-thickness burn to his leg after passing out against a kerosene heater. After ensuring that his airway, breathing, and circulation are intact, you cool the burn with water and then:

A) carefully remove smoldering fabric that is adhered to the skin.
B) cover the burn with a burn sheet soaked in warm sterile water.
C) carefully wrap the burn with a dry sterile dressing.
D) apply ice packs and secure in place with a sterile dressing.

Question 23

Why would an EMT be concerned about a partial-thickness burn circumferentially to the chest?

A) Impact on the heart
B) Large burn area
C) Restriction of breathing
D) Lung tissue involvement

Question 24

Which one of the following statements shows that the EMT understands the palm method of estimating the BSA burned?

A) "I do not use the palm method on young children since it is inaccurate."
B) "I use the patient's palm to estimate the size of the burn area."
C) "If I estimate that four palm areas fit into the burn, then that is about 8% BSA."
D) "I use the palm of my hand to estimate the area of the burn."

Question 25

A 51-year-old male was burned in the face after a steam valve was accidentally opened. His face is red and swollen, and he is screaming in pain. He also states that he is having a hard time seeing. Which of the following is the EMT's priority concern in caring for this patient?

A) Facial disfigurement
B) Airway compromise
C) Pain management
D) Loss of vision

Question 26

You have been called for a patient who had a large bag of lime powder tear as he was unloading it from a truck. On arrival he is complaining of burning to both legs and you note that aside from the shorts he is wearing, lime dust covers both legs. Your immediate action would be to:

A) brush as much of the lime off his legs as possible.
B) cut his clothes off to better assess the extent of the burns.
C) wash his legs off with large amounts of water.
D) move him to the stretcher for immediate transport.

Question 27

A patient has been pulled from a house fire. Assessment reveals him to be lethargic with stridorous respirations and a rapid but strong radial pulse. Firefighters are dousing his body with water to cool him. What action would the EMT perform immediately?

A) Determine if critical areas of the body have been burned.
B) Administer oxygen through a nonrebreather face mask and obtain a full set of vitals.
C) Begin removing the patient's clothes to determine the type of burn.
D) Provide positive pressure ventilation with a bag-valve mask.

Question 28

A 24-year-old man was shocked while working on his house's electrical system. Assessment reveals a minor burn to the fingers on his left hand. Aside from being slightly shaky, he states he feels fine and does not see the need to be treated further or transported to the hospital. What statement would you make before allowing him to refuse additional care and transport?

A) "You really need to be evaluated in the hospital emergency department. The shock puts you at high risk for a stroke within the next 48 hours."
B) "You need to get the burn site cleaned to avoid infection. This can be done in the hospital emergency department."
C) "Electrical burns typically increase in pain as time goes on. The hospital emergency department can give you pain medication."
D) "It would be best to let the emergency physician check you out. Electrical shocks can damage the heart."

Question 29

A male patient was injured when a steam valve opened, causing hot steam to contact his face. Which one of the following statements made by the patient would be of most concern to the EMT and require immediate assessment or treatment?

A) "I think the blisters are breaking."
B) "The pain is excruciating!"
C) "It is sort of hard to breathe."
D) "I think my neck is also burned."

Question 30

Of the actions that follow, which one indicates proper care of a patient who has suffered a partial-thickness burn to the hand?

A) Gently push the fingers together prior to applying a sterile dressing.
B) Carefully removal rings prior to applying a dry sterile dressing.
C) Carefully drain blisters to decrease pressure on the underlying tissues.
D) Clean dirt and debris from the burn prior to applying an antibiotic ointment.

Question 31

You have arrived on the scene of a large structure fire. Emergency Medical Responders (EMRs) are by the side of a patient who is responsive to verbal stimuli and has suffered significant burns to his body. They report that the patient fell down a flight of stairs while trying to escape and was trapped for several minutes. Their assessment findings include partial- and full-thickness burns to his right arm, right leg, and right side of the face. The EMRs also report that the patient's unburned skin is cool, clammy, and pale, with a delayed capillary refill. His pulse is 144, respirations are 22, and blood pressure is 88/50 mmHg. Which one of the following instructions would be most appropriate?

A) "The patient is in burn shock; let's cool him by pouring cold water on him now and during transport."
B) "After reassessing the ABCs, let's do a secondary assessment and look for signs of injuries that are causing shock."
C) "The patient is in burn shock; let's soak a sterile burn sheet in water and wrap it around him."
D) "Before cooling him with water, let's figure out the percentage of his body that is burned along with the type of burn."

Question 32

Firefighters have just pulled a young woman from a house fire and have laid her on the lawn. She is conscious and badly burned on the chest, abdomen, and legs. Her clothes are smoldering. Which one of the following actions should the EMT take immediately?

A) Place an oropharyngeal airway.
B) Determine the body surface area burned.
C) Apply oxygen via nonrebreather face mask.
D) Cool the burn with water.

Question 33

You are transporting a patient who was shocked by an electrical current while repairing a residential electrical service panel. He has partial-thickness burns to the hand and foot where the electricity entered and exited his body respectively. When reassessing the patient, what sign or symptom would be of most concern?

A) Increasing pain at burn sites
B) Palpation of an irregular heartbeat
C) Complaint of a headache
D) Swelling of the foot

Question 34

When applying the rule of nines to a 10-month-old child, the EMT should recognize which one of the following?

A) The head of a child is considered to be 18% of the total body.
B) Both legs combined are approximately 18% of the total body.
C) The front and back of the torso are considered 72% of the total body.
D) The front of the arm is approximately 9% of the total body.

Question 35

A burn patient has full-thickness burns to the fronts of both legs and the entire left arm. The front of the patient's right arm has superficial burns. Using the rule of nines, the EMT should estimate what percentage of the patient's body has been burned?

A) 32%
B) 45%
C) 27%
D) 36%

Question 36

You are assessing an elderly male patient who was trapped in a burning trailer. What finding would be most indicative that he has suffered an inhalation injury?

A) Coughing of black sputum
B) Heart rate of 126 beats per minute
C) Partial-thickness burn to the left side of the face
D) Blood coming from the nose

Question 37

A 44-year-old electrician has been shocked and responds to verbal stimuli with garbled speech. His airway is open and he is breathing poorly at a rate of 8 times per minute. His pulse is slow and irregular. What action would the EMT perform next?

A) Attach but do not turn on the automated external defibrillator.
B) Insert an oral airway and apply 15 lpm oxygen with a nonrebreather mask.
C) Obtain the patient's pulse, blood pressure, and pulse oximetry reading.
D) Ventilate with a bag-valve mask at 12 breaths per minute.

Question 38

A patient was trapped in a burning apartment before being rescued by firefighters. As you approach him, you note that his legs and arms are burned. He is screaming in pain and coughing, but no longer actively burning. Given this information, what intervention would you perform first?

A) Perform a secondary assessment to determine if non-burn injuries are present.
B) Estimate the percentage of the patient's body that has been burned.
C) Determine if the patient has suffered partial- or deep partial-thickness burns.
D) Decide whether to administer oxygen with a nonrebreather face mask or with a bag-valve mask.

Question 39

Which statement made by an EMT shows that he understands the major cause of death in the prehospital setting for a burn patient?

A) "Most burn patients who die before getting to the hospital die of airway or bleeding problems, not the burn itself."
B) "Most patients who die before getting to the hospital die from burn shock, caused by massive fluid loss from the burns."
C) "The most common cause of death for burn patients in the prehospital setting is infection, which can be minimized by applying a sterile burn sheet."
D) "Burn patients most often die before reaching the hospital from the increased body temperature caused by the heat of the burns."

Question 40

A patient has suffered partial- and full-thickness thermal burns to the anterior chest, abdomen, and arms in an industrial accident. What action would be appropriate in the care of this patient?

A) Cool the burns with water for 90 seconds and cover the burns with a sterile, dry burn sheet.
B) Cool the burns with water on scene and during rapid transport to the emergency department.
C) Cool the burns with water for 2 minutes and cover the burns with saline-soaked dressings soaked in sterile water.
D) Cool the burns on scene and apply ice packs to the burned areas during transport.

Question 41

Firefighters have pulled a middle-aged male from a burning bedroom. The patient is unresponsive and has obvious deformity of his left ankle. His respirations are rapid, stridorous, and shallow. Your partner inserts an oropharyngeal airway and begins ventilating the patient with a bag-valve mask. Which one of the following actions would you perform next?

A) Instruct your partner to hyperventilate the patient.
B) Find out how long the patient was in the burning structure.
C) Check the patient's breath sounds.
D) Assess the patient's carotid pulse.

Question 42

An awake but confused patient with a diabetic history spilled a pot of hot water on himself while cooking. He has a partial-thickness burn on his right anterior leg. Following an unremarkable primary assessment, which action is your highest priority?

A) Determine the percentage of body surface area burned.
B) Check the patient's blood glucose level.
C) Assess for signs of infection at the burn site.
D) Apply sterile dressings to the burn.

Question 43

Your patient is a 27-year-old male who fell down a full flight of stairs while escaping his burning apartment. What assessment finding should demand your immediate attention?

A) Tenderness to the right upper abdominal quadrant
B) Full-thickness burn on the hands
C) Burns on the face
D) Deformity of the left wrist

Question 44

An industrial worker has sustained a partial- and full-thickness burn to his right hand after accidentally touching an electric furnace used to incinerate medical waste. Assessment reveals no threats to the airway, breathing, or circulation. Which action would the EMT perform next?

A) Pour cool saline water on the hand.
B) Apply an antibiotic ointment to the burn.
C) Open any blisters to relieve pressure on the burned tissue beneath.
D) Gently clean dead skin away from the burn.

Question 45

An intoxicated 28-year-old female has suffered burns to both legs after passing out next to a space heater, which ignited her pants. Emergency Medical Responders have removed her clothing and cooled the burns. Which action is most appropriate in the continued care of this patient?

A) Carefully wrap the burn with a sterile wet burn sheet.
B) Cover the burns with a clean, white, dry sheet.
C) Place ice packs to the burn to continue cooling.
D) Clean the burn with sterile saline and cover gauze.